Chao Wen-Cheng, Lin Ching-Heng, Liao Tsai-Ling, Chen Yi-Ming, Chen Der-Yuan, Chen Hsin-Hua
Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
PLoS One. 2017 May 9;12(5):e0176549. doi: 10.1371/journal.pone.0176549. eCollection 2017.
To address the association between a history of tuberculosis (TB) or nontuberculous mycobacterial (NTM) infection and the risk of newly diagnosed Sjögren's syndrome (SS).
Using a nationwide, population-based, claims dataset, and after excluding those who had rheumatoid arthritis or systemic lupus erythematosus, we identified 5,751 newly diagnosed SS cases during 2007-2012, and compared them to 86,265 non-SS controls matched (1:15) for age, sex, and the year of first SS diagnosis date. The association between the risk of incident SS and a history of mycobacterial infection, including TB and NTM, was quantified by calculating odds ratios (ORs) with 95% confidence intervals (CIs) using conditional logistic regression analysis after adjustment for Charlson comorbidity index (CCI) and bronchiectasis.
The mean age was 55±14 years, and the proportion of female gender was 87.8% in both newly diagnosed SS cases andnon-SS controls. An association was observed between NTM infection (OR, 11.24; 95% CI, 2.37-53.24) and incident SS, but not between TB infection and incident SS (OR, 1.29; 95% CI, 0.97-1.71) after adjustment for CCI and bronchiectasis. The association between NTM and SS risk was remarkably strong among those aged between 45 and 65 years (OR, 39.24; 95% CI, 3.97-387.75) and those without bronchiectasis (OR, 39.98; 95% CI, 3.83-376.92).
The study reveals a significant association of newly diagnosed SS with a history NTM infection, especially among individuals aged 40-65 years or those without bronchiectasis.
探讨肺结核（TB）或非结核分枝杆菌（NTM）感染史与新诊断干燥综合征（SS）风险之间的关联。
利用全国性的基于人群的索赔数据集，并排除患有类风湿性关节炎或系统性红斑狼疮的患者后，我们在2007年至2012年期间确定了5751例新诊断的SS病例，并将其与86265名非SS对照者（年龄、性别和首次SS诊断年份匹配，比例为1:15）进行比较。在调整Charlson合并症指数（CCI）和支气管扩张后，通过条件逻辑回归分析计算比值比（OR）及95%置信区间（CI），对新发SS风险与包括TB和NTM在内的分枝杆菌感染史之间的关联进行量化。
新诊断的SS病例和非SS对照者的平均年龄均为55±14岁，女性比例均为87.8%。在调整CCI和支气管扩张后，观察到NTM感染与新发SS之间存在关联（OR，11.24；95%CI，2.37 - 53.24），而TB感染与新发SS之间无关联（OR，1.29；95%CI，0.97 - 1.71）。NTM与SS风险之间的关联在45至65岁人群（OR，39.24；95%CI，3.97 - 387.75）和无支气管扩张人群（OR，39.98；95%CI，3.83 - 376.92）中尤为显著。
该研究揭示了新诊断的SS与NTM感染史之间存在显著关联，尤其是在40 - 65岁个体或无支气管扩张的个体中。
